True Digital Artery Aneurysm of the Ring Finger: A Case Report

Abstract

True aneurysms of the digital artery are very rare. Only 13 cases, caused by chronic trauma from occupational or sports-related overuse, have been reported. We present the first case of a true aneurysm of the digital artery of the left ring finger caused by chronic repetitive trauma from a wedding ring. The patient was a 44-year-old teacher who presented with a 1.5-cm subcutaneous mass on the radial aspect of the proximal phalanx of the finger, just proximal to the proximal interphalangeal joint. Exploration of the mass revealed a 1-cm aneurysm continuous with the radial digital artery. The aneurysm was excised and the proximal and distal ends of the radial digital artery ligated. Microscopic examination of the excised specimen confirmed the diagnosis of a true aneurysm with the lumen filled with an organising thrombus. The patient had an uneventful recovery with good wound healing, intact sensation, and normal capillary return.

Post-traumatic false aneurysm in a digital artery of the finger

“…The usual mode of presentation is that of a slowlyenlarging mass that may be painful [2][3][4]. If the digital nerve is compressed by the aneurysm there may also be some sensory disturbance [5]. An appreciable number of previous case reports have described the mass as being non-pulsatile [4], probably because of the organising thrombus within the aneurysm, and in these cases the mass may be mistaken for an epidermoid cyst, a foreign-body granuloma, a neuroma, or an abscess.…”

“…An appreciable number of previous case reports have described the mass as being non-pulsatile [4], probably because of the organising thrombus within the aneurysm, and in these cases the mass may be mistaken for an epidermoid cyst, a foreign-body granuloma, a neuroma, or an abscess. The correct diagnosis is usually made intraoperatively or on histological examination [5][6][7].…”

True Digital Artery Aneurysm - A Clinical Vignette

“…The etiology of these aneurysms is repetitive micro trauma (commonly) 2 , congenital 3 secondary to inflammation or atherosclerosis 4 , or idiopathic 1 . These aneurysms are usually painless, but long standing aneurysms may have thrombus 5 formation leading to pain. Treatment options include excision with or without the need for interposition vein/arterial graft to preserve blood flow depending on the formation of collaterals.…”